Dysphagia

Patulous lower esophageal sphincter

July 31, 2007     Catherine J. Rees, MD; Peter C. Belafsky, MD, PhD
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A 46-year-old man presented to the Center for Voice and Swallowing with symptoms of globus, pyrosis, and solid-food dysphagia. Findings on transnasal esophagoscopy were normal except for the presence of a widely patulous lower esophageal sphincter (LES) .

Isolated uvulitis

July 31, 2007     Marc Cohen, MD; Dinesh K. Chhetri, MD; Christian Head, MD
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A 46-year-old woman presented to the emergency department with an 8-hour history of progressive throat pain, dysphagia, and odynophagia. Of note, she had begun her day by taking a magnesium oxide supplement for the first time. She reported no fever, chills, shortness of breath, trauma, or recent upper respiratory tract infection. Her medical history was significant for asthma, hypertension, and mitral valve prolapse. She also recalled an episode of acute tongue swelling during childhood.

Distal esophageal spasm

May 31, 2007     Catherine J. Rees, MD; Peter C. Belafsky, MD, PhD
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Anaplastic thyroid carcinoma

April 30, 2007     Troy Hutchins, MD; Paul Friedlander, MD; Enrique Palacios, MD, FACR
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Gastric carcinoma

March 31, 2007     Catherine J. Rees, MD; Peter C. Belafsky, MD, PhD
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Chronic esophageal stricture with Barrett's esophagus

February 1, 2007     Catherine J. Rees, MD; Peter C. Belafsky, MD, PhD
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Severe distal esophageal stricture

September 30, 2006     Sheldon R. Brown, MD
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The 'sentinel clot' sign in spontaneous retropharyngeal hematoma secondary to parathyroid apoplexy

August 31, 2006     George Koulouris, FRANZCR; Marcus Pianta, MBBS; Stephen Stuckey, FRANZCR
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Abstract
Spontaneous retropharyngeal hemorrhage from a cervical parathyroid adenoma is a rare complication of primary hyperparathyroidism. Because of its rarity, it has seldom been documented in the radiologic or ENT literature. Patients may present with a variety of manifestations, ranging from dysphagia to dysphonia to life-threatening dyspnea or hemorrhage. Awareness of a possible thyroid or parathyroid etiology may expedite treatment and prevent unnecessary interventions. We present a case of spontaneous retropharyngeal hemorrhage in which the "sentinel clot" sign enabled us to identify the lesion of origin.

Double swallow

July 31, 2006     Gregory N. Postma, MD; Lori M. Burkhead, PhD, CCC-SLP; William H. Moretz III, MD
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Fibrous dysplasia in the retropharyngeal area

June 30, 2006     Muharrem Gerceker, MD; Ozan Bagis Ozgursoy, MD; Atilla Erdem, MD; Cemil Ekinci, MD
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Abstract
More fibro-osseous lesions originate in the bones of the extremities than in the craniomaxillofacial bones, scapula, and ribs, which are rarely involved. Fibro-osseous lesions that decrease the quality of life should be treated surgically. We report the case of a fibro-osseous lesion that caused globus pharyngeus and dysphagia. We discuss the clinical, radiologic, and histopathologic features of this case as well as the removal of this unusual lesion by Doppler ultrasound-guided surgery. To the best of our knowledge, no other case of a fibro-osseous lesion in the retropharyngeal area has been reported in the literature.

Herpes simplex virus infection presenting as a piriform sinus mass

June 30, 2006     Laurie A. Brigandi, DO; Paul V. Lanfranchi, DO; Edward D. Scheiner, DO, FOCOO; Scott L. Busch, DO, FACS
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Abstract
Evidence is accumulating that herpes simplex virus (HSV) infection is implicated in oncogenesis. HSV antigens have been observed in some oral cancers. We present the case of a 62-year-old man who presented with dysphagia, odyno-phagia, and dysphonia and who was found on computed tomography (CT) to have a mass in his piriform sinus. We suspected a malignancy, but histopathology of biopsy specimens revealed that the mass exhibited the classic signs of the HSV cytopathic effect, including the presence of intranuclear inclusion bodies, ballooning degeneration of epithelial cells, and a ground-glass appearance of some nuclei. The patient responded well to antiviral therapy, and posttherapy CT revealed that the mass had resolved completely. To the best of our knowledge, this is the first report in the literature of a case of HSV infection presenting as a piriform sinus mass.

A french-fried foreign body

May 31, 2006     Peter C. Belafsky, MD, PhD
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